A clinical entity of cystic dilatation of the utricle associated with hemospermia
A clinical entity of cystic dilatation of the utricle associated with hemospermia
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DOI：
10.1097/01.ju.0000169494.48968.aa
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发表时间：
2005-09-01
影响因子：
6.6
通讯作者：
Kato, H
中科院分区：
文献类型：
--
作者：
Furuya, S;Kato, H
目的：我们研究了前列腺中线囊肿（MLC）患者血精的发生机制，重点探讨了胞囊性扩张（CDU）是一种可能的致病病变。材料与方法：138例血精症患者中30例（22%）有MLC，其中19例经会阴针穿刺MLC和双侧精囊确定出血部位。MLC抽吸后注入染料和造影剂的混合物。行内窥镜及盆腔x线检查。结果：19例患者中有13例1侧或2侧精囊液出血（6例抽吸失败），19例中有5例MLC液无出血（7例抽吸失败）。15例（79%）患者的MLC与尿道（CDU）相通，11例（58%）患者的MLC与1或2个射精管相通。在与射精管相通的11例患者中，有5例血精症持续1年以上。其中4例经尿道CDU开颅术治愈。结论：CDU是血精症的重要潜在病变。慢性血精症患者与射精管的沟通频繁，经尿道开颅术对消除血精症有效。
Purpose: We investigated the mechanism of hemospermia in patients with a midline cyst (MLC) of the prostate, focusing on cystic dilatation of the utricle (CDU) as a possible causative lesion.Materials and Methods: Of 138 patients with hemospermia 30 (22%) had an MLC, of whom 19 underwent transperineal needle aspiration of the MLC and bilateral seminal vesicles to determine the site of bleeding. Following MLC aspiration a mixture of dye and contrast medium was injected. The verumontanum was observed endoscopically and pelvic x-ray was done.Results: Seminal vesicle fluid on 1 or 2 sides was hemorrhagic in 13 of the 19 patients (aspiration failed in 6) and fluid from the MLC was nonhemorrhagic in 5 of the 19 (aspiration failed in 7). The MLC communicated with the urethra (CDU) in 15 patients (79%) and with 1 or 2 ejaculatory ducts in 11 (58%). In 5 of 11 patients with communication with the ejaculatory duct hemospermia persisted for more than 1 year. Four of these patients were cured by transurethral unroofing of the CDU.Conclusions: CDU is a significant underlying lesion for hemospermia. Communication with the ejaculatory ducts was frequent in patients with chronic hemospermia and transurethral unroofing was effective for eliminating hemospermia.